This review aimed to identify clinical, demographic, and investigation findings that are associated with treatment failure or mortality in children (aged two months to nine years) with pneumonia in LMICs.
METHODSWe conducted a systematic search of medical databases MEDLINE, EMBASE, and PubMed (for recent studies not yet indexed on MEDLINE) for studies reporting on factors associated with child pneumonia mortality (August 30, 2020). We mapped search terms to medical subject headings where possible, using Boolean operators to combine searches into our final systematic search query. We used synonyms of "pneumonia", "mortality", and "child" to target our search strategy, with oversight from an experienced Health Service Librarian to ensure all relevant papers were identified. We also searched reference lists of all included references for eligible studies. Additional methodological detail, including the Medline search strategy, information sources and data collection processes are included in Text S1 in the Online Supplementary Document.
Assessment of study eligibilityWe included observational and interventional studies from LMICs involving children aged 28 days to nine years with pneumonia and reporting data on risk factors for death. We focussed on studies published since 2010 to reflect current aetiology and diagnostic / treatment approaches and limited to English language. We included studies involving children older than five years of age as this is an important neglected child population but expected most studies to focus on the traditional under five-year population. Two reviewers (CW and MB) independently screened the titles and abstracts of all returned studies, obtained full text for studies that were screened in by either reviewer, then independently assessed them for inclusion. We resolved disagreements by discussion and, where appropriate, review by a third reviewer (HG). None of the reviewers were blind to the journal titles, study authors, or affiliated institutions.